Loading...
23D-142 (2) t Department: Reference No: BP-1999-0100 Building,Electrical& Mechanical Permits Fee Type: Receipt No: Roofing REC-1999-000167 Paid By: Paid in Full On: Robert Thibodo Tue Jul 21,1998 Received By: Check No: Linda Lapointe 6498 DEPARTMENT'S COPY Amount: $20.00 DEPARTMENT FILE COPY 108 HINCKLEY ST CITY OF NORTHAMPTON BUILDING PERMIT Owner's pulling their own permits or dealing with unregistered contractors for applicable work do not have access to Guaranty Fund(MGL 142A) Issued: Permit No: Inspector: Tracking No.: Fee: 21 Jul, 1998 BP-1999-0100 $20.00 GIS#: Map Block: Lot: Address: Zoning: Use Group: Lot Size: 3298 23D 142 001 108 HINCKLEY ST URB 3310.56 Contractor: License Type: Insurance: Robert Thibodo HIC Address: License No.: Insurance No.: P O Box 201 104465 City: State: Zip Code: Phone: NORTHAMPTON MA 01061 (413) 586-0391 Project No: Category of Work: Const. Class: Cost Estimate: JS-1999-0141 roofing $700.00 Description of Work: INSTALL SHINGLES TO REAR ROOF &EXTENSION GeoTMS®1997 Des Lauriers&Associates,Inc. Signature: 0 E R 11 jail ,1 0 4 r2I098 _ 6qqg File No. l3f�-_ 9 1 9 (re) t0_0 DEPT OF BUiLD!PIG IIdSPE(;TIOr` NORTH, °,' _•.A O ZONING PERMIT APPLICATION (§10 . 2) PLEA., E OR P ALL INFORMATION 1. Name of Applicant: l ' Address: elephonef D�l��,� a s> '77 2. Owner of Property: !y/ /1/I/ Address: //O ,(/�ey �. / elephone: L5; L 5 7F 3. Status of Applicant: Owner / Contract Purchase� essee Other(explain): 4. Job Location: M'O /ti,�� Parcel Id: Zoning Map# :. .�p Parcel# / District(s):_a; 17 (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property J F// 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): / i :..s,iiiireate4We‘Allr/ ee _d?.,/o �� I 7. Attached Plans: Sketch Plan Site Plan gineered/Surveyed Plans Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files. 8. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW YES IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES IF YES: enter Book Page and/or Document# 9. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained ,date issued: (FORM CONTINUES ON OTHER SIDE) 10 Do any signs exist on the property? YES NO IF YES, describe size,type and location: Are there any proposed changes to or additions of signs intended for the property?YES NO IF YES,describe size,type and location: 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. This column to be filled in by the Building Department !Required 1 Existing Proposed By Zoning Lot size Frontage Setbacks - frnnt - side L: R: L: R: - rear Building height Bldg Square footage %Open Space: (Lot area minus bldg &paved parking) # .of -Parking Spaces # of Loading Docks Fill: -(volume -& location) 13 . Cert " :tion: I hereby certify that the informa o contained rein is - an accurate to the best of my know ge. DATE ( APPLICANT's SIGNATURE 1� 11 N• E: 1 rue •e of zon ng , permit does not relieve en ap oant's burden t comply with all oning'req rements and obtain all required permits from the Board of Health. Conservation Commission. Department of Publio Works and other applioable permit granting authorities. FILE if ... o4iT„ j II@ Nf 9= �� :a fl l OlZ 1 of NL rtipti tptnn =*__L ini B�4 %tin ''r ' =:� 1._ Bits..,fj �las4acllnstti4 0_ 1` '7 DEPT©FBUppn,,-,-- d DEPARTMENT OF BUILDING INSPECTIONS ='__�f . NORTH.rI,�,. ,INSPECTION — • �:__ ' •,0 212 Main Street ' Municipal Building ' •w--"'—'-' Northampton, Mass. 01060 �" �'���' O R'S CO TION INSURANCE AFFIDAVIT I, ' 2)/ , /--e----25 . (licenser/permittee) with a principal place of business/r ' ence at: l 1r / / /3Q hone# (btiwt/city/ .p) y75." do hereby certify, under the pains and penalties of perjury, that: ( ) I am an employer providing the following worker's compensation coverage for my employees working on this job: (Insurance Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional sheet ifnecessary to include information pertaining to all contractors) _. am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself NOTE:please be aware that while homeowners who employ persons to do ma frrte+f anr,,construction or repair work on a dwelling of not more than three units in which the homeowner resides or on the grounds appurtenant thereto are not generally considered to be employers under the worker's compertsatien Act(GL152,sa 1(5)),application by a homeowner for a license or permit may evidcaoe the legal status of an employer under the Worker's Compensation Act I understand that a copy of this autement may be forwarded to the Department of Industrial Accident&Office of Inwranoe for the coverage verification 4ad that failure to secure coverage under section.25A of MOL 152 can lead to the imposition of criminal penalties ... consisting of a fine of up to$1,500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a fine of S 100.00 a day against me. Sign der f 199 r For departmental UM only Permit Number Map# Lot# Sire of Li errs .., '° . tz i) T O :ce1;:!,,==..1-1:) §c..--•-J-.)..1iV. F 3 c r547o i :"-t91 -. -J\ 1I:t__ ..0... Sf> 0i7,>mm0l �.M Z LW Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.0: D 39/ Alterations ikr—:r NORTHAMPTON, MASS. 19 Additions APPLICAT ON R P RMIT TO ALTER Repair Garage g 1. Location e ,eO, L t No. 2. Owner's name A dress f .Y' 3. Builder's name Address di.3o/ Mass.Construction Supervisor's License No. �ov749/Expiration Date 4. Addition / 5. Alteration 6. New Porch 7. Is existing building to be demolished? 8. Repair after the fire 9. Garage No.of cars Size 10. Method of heating 11. Distance to lot lines 12. Type of roof .a - 13. Siding house 14. Estimated cost:- 9, ����,� The undersigned ce ' es th the above stat n true to the best of his, her knowledge and li , Signature of responsible appicant Remarks